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Nail Problems and Injuries

Topic Overview

Minor fingernail and toenail problems are common. At one time or
another, almost everyone has caught a nail on something, causing it to rip, or
has smashed a finger in a door, leaving blood under the nail. These kinds of
injuries can be quite painful but are usually not serious. You can often
relieve pain and prevent infection of minor nail problems at home.

Normally, fingernails grow about one-tenth of a millimeter each day.
Toenails grow at about one-half or one-third the rate of the fingernails. Aging
and diseases that decrease blood flow to the hands and feet may slow nail
growth.

Common nail changes include:

Splitting, peeling, or brittle nails. These are
common problems that develop when your hands are frequently exposed to water,
strong soaps, and other chemicals. You may be able to prevent some of these
problems if you use lotion and avoid repeatedly putting your hands in
water.

Little white marks (leukonychia) often appear
after minor injuries. They may last for weeks or months and usually go away on
their own.

It is common for a nail to turn black after an injury.
The black or purple-black color is caused by blood under the nail and will go
away as the injury heals.

Black, brown, or purple discoloration
under a nail that has not been injured may be caused by
melanoma.

Changes in the shape or texture of nails, which may occur for a variety of reasons. Some nail changes, such
as the formation of ridges, are normal with aging. Thick, brittle, or dark
nails are more common in older adults who have poor
circulation.

Ingrown nails, which are often caused by improper
trimming, tight shoes, or heredity. Your nails may grow into the surrounding
skin, causing pain, swelling, and
infection. In rare cases, an
abscess may develop under a nail (subungual
abscess).

Separation from the nail bed. Once your
nail separates from its nail bed, for whatever reason, it will not reattach.
Nails grow back slowly. It takes about 6 months for fingernails and up to 18
months for toenails to grow back attached to the nail bed.

Infection and allergic reactions. These are common
problems caused by
artificial nails.

Severe pain (8 to 10): The pain
is so bad that you can't stand it for more than a few hours, can't sleep, and
can't do anything else except focus on the pain.

Moderate pain (5 to 7): The pain is bad enough to disrupt your
normal activities and your sleep, but you can tolerate it for hours or days.
Moderate can also mean pain that comes and goes even if it's severe when it's
there.

Mild pain (1 to 4): You notice the pain,
but it is not bad enough to disrupt your sleep or activities.

Symptoms of infection may
include:

Increased pain, swelling, warmth, or redness in or
around the area.

Red streaks leading from the area.

Pus draining from the area.

A fever.

Home Treatment

Home treatment can help relieve
pain, prevent infection, and promote healing. To relieve pain from an injury to
the nail, try the following:

Apply ice and elevate the injured nail area as
soon as possible after the injury.

Aspirin (also a nonsteroidal
anti-inflammatory drug), such as Bayer or Bufferin

Talk to your child's doctor before switching back and
forth between doses of acetaminophen and ibuprofen. When you switch between two
medicines, there is a chance your child will get too much medicine.

Safety tips

Be sure to follow these
safety tips when you use a nonprescription medicine:

Carefully read and follow all directions
on the medicine bottle and box.

To prevent a fungal nail infection:

Keep your feet clean and dry. Dry feet are less
likely to become infected. Apply powder to your feet when
needed.

Wear clean, dry socks. Change your socks once a day or more
frequently if they become wet.

Wear roomy shoes that allow air to
circulate around your feet.

Wear shower sandals or shower shoes
when you use public pools, spas, and showers.

To prevent problems with artificial nails:

Test for a reaction to the artificial nail by
having just one nail applied. Wait several days to see whether redness,
itching, pain, or rash around or under the nail or separation of the nail from
the nail bed develops.

Do not apply an artificial nail if the nail
or the skin around the nail looks irritated or infected.

If an
artificial nail does separate from the nail bed, dip your fingertip into
rubbing alcohol for 15 seconds before reattaching the artificial nail. This
will clean the space between the nails.

Do not wear artificial
nails for longer than 3 months at a time. Give your natural nails a month to
rest before reapplying artificial nails.

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